Provider Demographics
NPI:1629750104
Name:THOMPSON, SUZANNE M (BCMHC)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:M
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:BCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 THOMPSON ACRES
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MS
Mailing Address - Zip Code:39654-4501
Mailing Address - Country:US
Mailing Address - Phone:601-695-5511
Mailing Address - Fax:
Practice Address - Street 1:80 HENRY COX RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MS
Practice Address - Zip Code:39654-9696
Practice Address - Country:US
Practice Address - Phone:601-695-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach